U.S. patent application number 15/765929 was filed with the patent office on 2018-10-04 for natural orifice translumenal minimally invasive surgical apparatus.
The applicant listed for this patent is TIANJIN UNIVERSITY. Invention is credited to Shuxin WANG, Junbo WEI, Guokai ZHANG.
Application Number | 20180280010 15/765929 |
Document ID | / |
Family ID | 57674169 |
Filed Date | 2018-10-04 |
United States Patent
Application |
20180280010 |
Kind Code |
A1 |
WANG; Shuxin ; et
al. |
October 4, 2018 |
NATURAL ORIFICE TRANSLUMENAL MINIMALLY INVASIVE SURGICAL
APPARATUS
Abstract
Disclosed is a natural orifice translumenal minimally invasive
surgical apparatus comprising a control box assembly sequentially
connected with a hose assembly, a serpentine structure and a tip
assembly at a middle position at a distal end of the control box
assembly. Axes of the hose assembly and the serpentine structure
are coincident with an axis of the tip assembly. The control box
assembly is configured to position and replace a minimally invasive
surgical instrument, support the surgical tool when being operated,
and perform a minimally invasive surgery. The hose assembly is
configured to provide passageways for the minimally invasive
surgical instrument and a transmission wire and to output motions
and loads. The tip assembly is configured to support the minimally
invasive surgical instrument when being operated and enable the
surgical instrument to have an enlarged motion space range. The
apparatus has advantages including convenient operation, accurate
actions and good real-time performance, achieves the basic goal of
minimally invasive surgery, expands the flexibility of the
movement, increases the operating space of the surgical
instruments, and enables the minimally invasive surgery to be
carried out in a handheld manner.
Inventors: |
WANG; Shuxin; (Tianjin,
CN) ; ZHANG; Guokai; (Tianjin, CN) ; WEI;
Junbo; (Tianjin, CN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
TIANJIN UNIVERSITY |
Tianjin |
|
CN |
|
|
Family ID: |
57674169 |
Appl. No.: |
15/765929 |
Filed: |
June 9, 2017 |
PCT Filed: |
June 9, 2017 |
PCT NO: |
PCT/CN2017/087729 |
371 Date: |
April 4, 2018 |
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/00991
20130101; A61B 2217/007 20130101; A61B 2017/00318 20130101; A61B
2017/3445 20130101; A61B 2017/003 20130101; F16H 19/06 20130101;
A61B 2017/00876 20130101; A61B 2017/00477 20130101; A61B 2017/2906
20130101; A61B 2017/00818 20130101; A61B 2017/00398 20130101; A61B
17/00234 20130101; A61B 2017/00278 20130101; A61B 17/3421
20130101 |
International
Class: |
A61B 17/00 20060101
A61B017/00; F16H 19/06 20060101 F16H019/06 |
Foreign Application Data
Date |
Code |
Application Number |
Aug 27, 2016 |
CN |
201610751855.7 |
Claims
1. A natural orifice translumenal minimally invasive surgical
apparatus, comprising a control box assembly, a hose assembly, a
serpentine structure, and a tip assembly, wherein, the control box
assembly is sequentially and fixedly connected with the hose
assembly, the serpentine structure and the tip assembly at a middle
position of a distal end thereof; the control box assembly
comprises: a control box housing having a rear wall provided with a
quick-change device at either side thereof, the quick-change device
including an upper connection sleeve into which a surgical tool is
inserted; and a triangular drive assembly including a knob cap
operable to move the tip assembly at the distal end; and the hose
assembly comprises an outer fixing sheath having a front end
connected with an outer shell in which the serpentine structure is
mounted.
2. The apparatus according to claim 1, wherein the triangular drive
assembly comprises a toggle lever passing through a middle portion
of an upper housing of the control box assembly; the toggle lever
is connected with the knob cap by a key at a top portion thereof,
rotatably connected onto a holder by a connection pin at a rear end
of a bottom portion thereof, and rotatably connected with a rear
end of a pull rod by a connection pin at a front end of the bottom
portion thereof, the pull rod being rotatably connected with a
slider by a pin at a front end thereof; the slider is slidably
connected with the holder by a guide rail and slider structure, the
holder is fixed onto a partition plate of the control box assembly,
a spring is fixed to a front end of the slider at a rear end
thereof and is fixed on a front wall of the holder at a front end
thereof, and the slider has a sliding axis coincident with an axis
of a guide rail of the holder; and the apparatus further comprises
a linear transmission wire having one end fixedly connected to one
end of a triangular wire joint and the other end sequentially
passing through a distal sheath assembly of the control box
assembly, the hose assembly and the serpentine structure and then
connected to a rear end of a transmission wire of the tip
assembly.
3. The apparatus according to claim 1, wherein the control box
assembly further comprises two rotary switches; each of the rotary
switches comprises a swinging rod, at a top of which a swinging
wheel is fixed, and a threaded bracket formed with a center hole in
a top wall thereof and a cavity communicating with the center hole
in a middle portion thereof; the swinging rod has a lower portion
passing through the center hole of the threaded bracket and
extending into the cavity, and is engaged with the center hole of
the threaded bracket through a clearance fit; and an
externally-toothed gear is fixed to a bottom portion of the
swinging rod located in the threaded bracket, and an upper magnet
assembly is fixed to a bottom wall of the externally-toothed
gear.
4. The apparatus according to claim 3, wherein the threaded bracket
is fixed to a threaded seat, which is fixed onto a fixing plate by
a fixing bolt; an internally-geared ring is fixed in the threaded
bracket; a lower magnet assembly is fixed in an inner wall of a
bottom portion of the threaded seat at a position opposite to the
upper magnet assembly; the externally-toothed gear is supported on
a thrust spring; the upper magnet assembly is wrapped within the
thrust spring; the thrust spring has an upper end in contact with a
lower end of the externally-toothed gear in a non-stressed state
thereof and a lower end fixedly connected with the lower magnet
assembly; a packing washer is sleeved over the thrust spring
located at a lower portion of the internally-geared ring to
radially fix the thrust spring; axes of the internally-geared ring
and the externally-toothed gear are coincident with an axis of the
swinging rod, and the swinging rod is movable in an up-and-down
direction to cause the internally-geared ring to engage with or
disengage from the externally-toothed gear; and sprockets are
mounted on the swinging rod located at an upper part of the
threaded bracket.
5. The apparatus according to claim 4, wherein a set of chutes are
fixed to the partition plate at a front side of each of the
sprocket, respectively; each set of chutes comprises two chutes
disposed at a predetermined interval, and the sprocket on each
swinging rod is engaged with a chain surrounding the sprocket; each
of the chains has two free ends disposed within the two chutes of
one set of the chutes, respectively, and the chain is drivable by
the swinging rod to reciprocate linearly in the chute; and both of
the free ends of each chain are connected with one end of four
transmission wires, and the other end of each of the four
transmission wires sequentially passes through the distal sheath
assembly, a guide wire hole of a connection ring of the hose
assembly and a guide wire hole of the serpentine structure and is
then fixed in an rear end opening of a tip body of the tip
assembly.
6. The apparatus according to claim 1, wherein the two quick-change
devices comprises two lower connection sleeves fixedly connected on
the left and right sides of a rear wall of a lower housing of the
control box housing, respectively; each of the lower connection
sleeves has a front end fixedly connected with a rear end of the
tool tube at a corresponding side; each of the lower connection
sleeves is sleeved with and fixed to an outer telescopic sleeve
having a center hole into which a middle telescopic sleeve is
slidably inserted, and the middle telescopic sleeve has a center
hole into which an inner telescopic sleeve is slidably inserted; an
upper connection sleeve is fixed to a rear end of the inner
telescopic sleeve and is symmetrically formed with two rectangular
slots of the same structure at either side along an axis thereof,
and two unlocking bars of the same structure each comprise a
straight bar segment inserted into the rectangular slot at a
corresponding side through a clearance fit; the straight bar
segment has a rear end provided with a protruding hook hooked with
a groove in the surgical tool and a front end connected with a
pressing plate, and the bar segment of each unlocking bar is
rotatably connected with the upper connection sleeve by a rotation
shaft; and the upper connection sleeve has a portion opposite to
the pressing plate and fixedly connected with a push rod by a
spring, wherein the pressing plate is allowed to be in contact with
a top portion of the push rod when the unlocking bar is rotated
about the rotation shaft.
7. The apparatus according to claim 1, wherein the tip assembly
comprises a tip body and an opening-closing body mounted in a
middle groove of the tip body; the opening-closing body includes
two triangular rings having the same structure and symmetrically
arranged in a left-and-right direction, and a triangular pulling
rod is disposed at a middle position between the two triangular
rings; each of the triangular rings is symmetrically provided with
a cylindrical boss and a cylindrical hole at either side thereof,
wherein the cylindrical boss has an axis parallel to an axis of the
cylindrical hole and perpendicular to an axis of the triangular
ring, and each of the cylindrical bosses is rotatably connected
with one end of each of links comprising two front links and two
rear links, and the other ends of the two front links and the two
rear links are respectively rotatably connected to front and the
rear ends of the triangular pulling rod by pins; a front end of a
stretching wire is vertically and fixedly connected onto the
triangular pulling rod, a triangular spring is sleeved over the
stretching wire, and a rear end of the stretching wire passes
through a middle opening of the tip body in which a boss is
arranged; the triangle spring is disposed in the middle opening
with a predetermined gap therebetween and is fixedly connected to
the boss at a lower end thereof, wherein in a state where axes of
the two triangular rings are parallel with each other, an upper end
of the triangular spring is in contact with a bottom end of the
triangular pulling rod, and each cylindrical hole is rotatably
connected with a cylindrical side of a triangular pin fixed onto
the tip body, so that the triangular ring is rotatable about the
triangular pin; and the tip body is provided with arc grooves in a
middle slotted inner wall thereof corresponding to the four
cylindrical bosses, and an end portion of each cylindrical boss of
the triangular rings is slidably disposed in a corresponding one of
the arc grooves, the cylindrical boss is slidable back and forth in
the arc groove, and the triangular pulling rod, the links, the
triangular pin and the triangular ring are rotatably connected
together to form a four-link mechanism.
8. The apparatus according to claim 1, further comprising a
water-air switch connected onto the upper housing.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application claims the benefit of Chinese Patent
Application No. CN201610751855.7 filed on Aug. 27, 2016 in the
State Intellectual Property Office of China, the whole disclosure
of which is incorporated herein by reference.
BACKGROUND
Field of the Disclosure
[0002] The disclosure relates to a minimally invasive surgical
apparatus, and more particularly to a natural orifice translumenal
minimally invasive surgical apparatus.
Description of the Related Art
[0003] A natural orifice translumenal minimally invasive surgery
does not leave any incision in a human body surface during treating
a patient's disease, thereby mitigating a surgical trauma and
postoperative pain and increasing a cosmetic result, thus achieving
better physiological and psychological minimally invasive effects.
For those persons who are obese, have poor health and scar
constitution, and pursue better cosmetic results, this natural
orifice translumenal minimally invasive surgery will be their best
choice. However, surgical instruments are lack of flexibility and
the surgical images are two-dimensional images, which increases
difficulty of a surgical operation. As a result, a natural orifice
translumenal surgical apparatus capable of increasing the
flexibility of the surgical instruments and providing
three-dimensional surgical images is proposed. During minimally
invasive surgery, a surgeon performs surgical procedures by means
of a slender minimally invasive surgical instrument. One end of the
surgical instrument is operated by the surgeon, so that the other
end of the surgical instrument is inserted into a human body
through a natural orifice thereof for a surgical operation.
Therefore, the surgical instrument is the only part in contact with
a diseased tissue of the human body and the only tool for directly
performing the surgical operation. During performing the surgery,
since there is a special mapping relationship between movement of a
distal end of the surgical instrument away from the surgeon and
movement of a proximal end thereof handled by the surgeon, in order
to satisfy operational requirements of different surgical
operations (clamping, suturing, knotting, etc.), the surgeon must
hold the surgical instrument to be moved in a large range, which
may reduce flexibility of the distal end of the surgical instrument
when performing surgical actions. Further, the long period and wide
range operation will make the surgeon prone to fatigue, virtually
increasing the difficulty of the surgical operation.
SUMMARY
[0004] The disclosure provides a natural orifice translumenal
minimally invasive surgical apparatus, characterized in comprising
a control box assembly, a hose assembly, a serpentine structure,
and a tip assembly. The control box assembly is sequentially and
fixedly connected with the hose assembly, the serpentine structure
and the tip assembly at a middle position of a distal end thereof.
The control box assembly comprises a control box housing having a
rear wall provided with a quick-change device at either side
thereof, the quick-change device including an upper connection
sleeve into which a surgical tool is inserted, and a triangular
drive assembly including a knob cap operable to move the tip
assembly at the distal end. The hose assembly comprises an outer
fixing sheath having a front end connected with an outer shell in
which the serpentine structure is mounted.
[0005] Further, the triangular drive assembly comprises a toggle
lever passing through a middle portion of an upper housing of the
control box assembly. The toggle lever is connected with the knob
cap by a key at a top portion thereof, rotatably connected onto a
holder by a connection pin at a rear end of a bottom portion
thereof, and rotatably connected with a rear end of a pull rod by a
connection pin at a front end of the bottom portion thereof, the
pull rod being rotatably connected with a slider by a pin at a
front end thereof. The slider is slidably connected with the holder
by a guide rail and slider structure, the holder is fixed onto a
partition plate of the control box assembly, a spring is fixed to a
front end of the slider at a rear end thereof and is fixed on a
front wall of the holder at a front end thereof, and the slider has
a sliding axis coincident with an axis of a guide rail of the
holder. The apparatus further comprises a linear transmission wire
having one end fixedly connected to one end of a triangular wire
joint and the other end sequentially passing through a distal
sheath assembly of the control box assembly, the hose assembly and
the serpentine structure and then connected to a rear end of a
transmission wire of the tip assembly.
[0006] Furthermore, the control box assembly further comprises two
rotary switches. Each of the rotary switches comprises a swinging
rod, at a top of which a swinging wheel is fixed, and a threaded
bracket formed with a center hole in a top wall thereof and a
cavity communicating with the center hole in a middle portion
thereof. The swinging rod has a lower portion passing through the
center hole of the threaded bracket and extending into the cavity,
and is engaged with the center hole of the threaded bracket through
a clearance fit. An externally-toothed gear is fixed to a bottom
portion of the swinging rod located in the threaded bracket, and an
upper magnet assembly is fixed to a bottom wall of the
externally-toothed gear.
[0007] Moreover, the threaded bracket is fixed to a threaded seat,
which is fixed onto a fixing plate by a fixing bolt. An
internally-geared ring is fixed in the threaded bracket. A lower
magnet assembly is fixed in an inner wall of a bottom portion of
the threaded seat at a position opposite to the upper magnet
assembly. The externally-toothed gear is supported on a thrust
spring. The upper magnet assembly is wrapped within the thrust
spring. The thrust spring has an upper end in contact with a lower
end of the externally-toothed gear in a non-stressed state thereof
and a lower end fixedly connected with the lower magnet assembly. A
packing washer is sleeved over the thrust spring located at a lower
portion of the internally-geared ring to radially fix the thrust
spring. Axes of the internally-geared ring and the
externally-toothed gear are coincident with an axis of the swinging
rod, and the swinging rod is movable in an up-and-down direction to
cause the internally-geared ring to engage with or disengage from
the externally-toothed gear. Sprockets are mounted on the swinging
rod located at an upper part of the threaded bracket.
[0008] Furthermore, a set of chutes are fixed to the partition
plate at a front side of each of the sprocket, respectively. Each
set of chutes comprises two chutes disposed at a predetermined
interval, and the sprocket on each swinging rod is engaged with a
chain surrounding the sprocket. Each of the chains has two free
ends disposed within the two chutes of one set of the chutes,
respectively, and the chain is drivable by the swinging rod to
reciprocate linearly in the chute. Both of the free ends of each
chain are connected with one end of four transmission wire, and the
other end of each of the four transmission wires sequentially
passes through the distal sheath assembly, a guide wire hole of a
connection ring of the hose assembly and a guide wire hole of the
serpentine structure and is then fixed in an rear end opening of a
tip body of the tip assembly.
[0009] In addition, the two quick-change devices comprise two lower
connection sleeves fixedly connected on the left and right sides of
a rear wall of a lower housing of the control box housing,
respectively. Each of the lower connection sleeves has a front end
fixedly connected with a rear end of the tool tube at a
corresponding side. Each of the lower connection sleeves is sleeved
with and fixed to an outer telescopic sleeve having a center hole
into which a middle telescopic sleeve is slidably inserted, and the
middle telescopic sleeve has a center hole into which an inner
telescopic sleeve is slidably inserted. An upper connection sleeve
is fixed to a rear end of the inner telescopic sleeve and is
symmetrically formed with two rectangular slots of the same
structure at either side along an axis thereof, and two unlocking
bars of the same structure each comprise a straight bar segment
inserted into the rectangular slot at a corresponding side through
a clearance fit. The straight bar segment has a rear end provided
with a protruding hook hooked with a groove in the surgical tool
and a front end connected with a pressing plate, and the bar
segment of each unlocking bar is rotatably connected with the upper
connection sleeve by a rotation shaft. The upper connection sleeve
has a portion opposite to the pressing plate and fixedly connected
with a push rod by a spring, wherein the pressing plate is allowed
to be in contact with a top portion of the push rod when the
unlocking bar is rotated about the rotation shaft.
[0010] Further, the tip assembly comprises a tip body and an
opening-closing body mounted in a middle groove of the tip body.
The opening-closing body includes two triangular rings having the
same structure and symmetrically arranged in a left-and-right
direction, and a triangular pulling rod is disposed at a middle
position between the two triangular rings. Each of the triangular
rings is symmetrically provided with a cylindrical boss and a
cylindrical hole at either side thereof, wherein the cylindrical
boss has an axis parallel to an axis of the cylindrical hole and
perpendicular to an axis of the triangular ring, and each of the
cylindrical bosses is rotatably connected with one end of each of
links comprising two front links and two rear links, and the other
ends of the two front links and the two rear links are respectively
rotatably connected to front and the rear ends of the triangular
pulling rod by pins. A front end of a stretching wire is vertically
and fixedly connected onto the triangular pulling rod, a triangular
spring is sleeved over the stretching wire, and a rear end of the
stretching wire passes through a middle opening of the tip body in
which a boss is arranged. The triangle spring is disposed in the
middle opening with a predetermined gap therebetween and is fixedly
connected to the boss at a lower end thereof, wherein in a state
where axes of the two triangular rings are parallel with each
other, an upper end of the triangular spring is in contact with a
bottom end of the triangular pulling rod, and each cylindrical hole
is rotatably connected with a cylindrical side of a triangular pin
fixed onto the tip body, so that the triangular ring is rotatable
about the triangular pin. The tip body is provided with arc grooves
in a middle slotted inner wall thereof corresponding to the four
cylindrical bosses, and an end portion of each cylindrical boss of
the triangular rings is slidably disposed in a corresponding one of
the arc grooves, the cylindrical boss is slidable back and forth in
the arc groove, and the triangular pulling rod, the links, the
triangular pin and the triangular ring are rotatably connected
together to form a four-link mechanism.
[0011] In addition, the natural orifice translumenal minimally
invasive surgical apparatus further comprises a water-air switch
connected onto the upper housing.
[0012] The present disclosure at least provides follow advantageous
effects: the disclosure provides a manual operation device based on
wire transmission, which employs wire transmission technology, and
thus has small overall structure in volume and is convenient in
operation. The deformable hose assembly and the openable tip
assembly are adopted to passively realize the surgical operation of
the surgical instrument and expand the surgical flexibility of the
surgical instrument, thereby facilitating the surgical operation by
the surgeon. When completing a surgical operation, the knob switch
is operated to lock and unlock the surgical instrument and set the
body position of the minimally invasive surgery according to the
desired action of the surgeon, thereby facilitating the smooth
progress of minimally invasive surgery with safe and efficient and
strong operability. Further, there are two functions including
providing exchangeable surgical instruments and rapid exchanging
instrument tools. Thus, flexible actions in minimally invasive
surgery can be effectively achieved to meet the requirements of
different surgical operation tasks.
BRIEF DESCRIPTION OF THE DRAWINGS
[0013] In order to make objects, technical solutions and beneficial
effects of the present disclosure clearer, the disclosure provides
the following drawings for illustration.
[0014] FIG. 1 is a schematic structural view of an overall
structure of a natural orifice translumenal minimally invasive
surgical apparatus according to an embodiment of the
disclosure;
[0015] FIG. 2A is a schematic structural view of an overall
structure of a control box assembly of a natural orifice
translumenal minimally invasive surgical apparatus according to an
embodiment of the disclosure;
[0016] FIG. 2B is a schematic structural view of an internal
structure of the control box assembly shown in FIG. 2A;
[0017] FIG. 2C is a schematic view of a triangular driving assembly
of the control box assembly shown in FIG. 2A;
[0018] FIG. 2D is a schematic structural view of a rotary switch of
the control box assembly shown in FIG. 2A;
[0019] FIG. 2E is a schematic structural view of a quick-change
device of the control box assembly shown in FIG. 2A;
[0020] FIG. 3A is a schematic structural view of a tip assembly of
a natural orifice translumenal minimally invasive surgical
apparatus according to an embodiment of the disclosure;
[0021] FIG. 3B is a schematic structural view of an opening and
closing body of the tip assembly shown in FIG. 3A;
[0022] FIG. 3C is a schematic structural view of a tip body of the
tip assembly shown in FIG. 3A;
[0023] FIG. 3D is a schematic view of an initial attitude of the
tip assembly shown in FIG. 3A;
[0024] FIG. 3E is a schematic view of the tip assembly shown in
FIG. 3A, showing an enlarged triangular operation region;
[0025] FIG. 4 is a schematic structural view of a hose assembly in
a natural orifice translumenal minimally invasive surgical
apparatus according to an embodiment of the disclosure;
[0026] FIG. 5 is a schematic structural view of a surgical tool
installed in a natural orifice translumenal minimally invasive
surgical apparatus according to an embodiment of the disclosure;
and
[0027] FIG. 6 is a schematic view of application of a natural
orifice translumenal minimally invasive surgical apparatus
according to an embodiment of the disclosure in a stomach surgical
operation.
DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
[0028] The preferred embodiments of the disclosure will be
described in further detail below, by way of example, with
reference to the accompanying drawings.
[0029] It should be noted that directional terms such as "upper",
"lower", "front", "rear", "left", "right", "proximal", "distal" and
the like mentioned in the disclosure only refer to directions
described with reference to the accompanying drawings, rather than
limiting the scope of the disclosure. The same elements are denoted
by the same or similar reference numerals throughout the drawings.
Conventional structures or constructions may be omitted as they may
cause confusion about the understanding to the disclosure. In
addition, a shape and a size of each component in the drawings do
not reflect the true size and scale thereof, and merely illustrate
the content of the embodiments of the disclosure.
[0030] FIG. 1 is a schematic structural view of an overall
structure of a natural orifice translumenal minimally invasive
surgical apparatus according to an embodiment of the disclosure.
The natural orifice translumenal minimally invasive surgical
apparatus comprises a control box assembly 300, a hose assembly 400
fixedly connected at a middle position at a distal or front end of
the control box assembly 300, and a serpentine structure 500 and a
tip assembly 600 provided within the hose assembly 400. Axes of the
hose assembly 400, the serpentine structure 500 and the tip
assembly 600 coincide with each other. The control box assembly 300
is connected with left and right surgical tools 100, 200 at a
proximal or rear end thereof.
[0031] Referring to FIGS. 2A and 2B, the control box assembly 300
is a manipulation assembly of the natural orifice translumenal
minimally invasive surgical apparatus. In some embodiments, the
control box assembly 300 may comprise a front sheath assembly 101
having a rear end fixedly connected with a front end of a control
box housing 107. The front sheath assembly 101 provides passages
for the surgical tools 100 and 200 and for a drive wire for control
action of the control box assembly 300. Therefore, the front sheath
assembly 101 has a predetermined rigidity, and thus plays an
important connecting role. The front sheath assembly 101 has a
front end sequentially connected with the serpentine structure 500
and the tip assembly 600 by the hose assembly 400. Specifically,
the control box housing 107 may include a lower housing and an
upper housing fixed onto the lower housing. A fixing plate 113 is
fixed to the lower housing by a pin. Two tool tubes 114 with the
same structure are fixed onto the fixing plate 113 by a pressing
block 115 and arranged symmetrically in a left-and-right direction.
A front end of each of the tool tubes 114 is disposed within the
front sheath assembly 101 at thereof. The tool tube 114 serves as a
passage for the surgical tool. Partition plates 112 may be fixed on
the fixing plate 113 by a pin, and chutes 110 may be fixedly
connected to the partition plate 112 by a pin, respectively.
[0032] Referring to FIG. 2A, the control box assembly 300 may
further comprise a triangular drive assembly 102 connected between
the partition plates 112. The triangular drive assembly 102
includes a knob cap 201 operable by a surgeon to achieve movement
of the tip assembly 600.
[0033] In some embodiments, the triangular drive assembly 102 may
comprise a toggle lever 202 passing through a middle portion of the
upper housing. The knob cap 201 is connected to a top portion of
the toggle lever 202 by a key. The knob cap 201 can serve as a
manually operated object for pulling the toggle lever 202 back and
forth. The toggle lever 202 is rotatably connected onto a holder
203 by a connection pin at a rear end of a bottom thereof so as to
rotate about the connection pin. Further, the toggle lever 202 is
rotatably connected with a rear end of a pull rod 207 by a
connection pin at a front end of the bottom thereof. The pull rod
207 is rotatably connected with a slider 204 by a pin at a front
end thereof. The slider 204 is slidably connected with the holder
203 by a guide rail and slider structure, thereby rotation of the
toggle lever 202 can be converted into a linear movement of the
slider 204. The holder 203 is fixed onto the partition plate 112. A
spring 205 is fixed to a front end of the slider 204 at a rear end
thereof and is fixed on a front wall of the holder 203 at a front
end thereof. The slider 204 has a sliding axis coincident with an
axis of a guide rail of the holder 203. A linear transmission wire
117 has one end fixedly connected to one end of a triangular wire
joint 206 and the other end sequentially passing through the front
sheath assembly 101, a guide wire hole in a connection ring 702 of
the hose assembly 400 and the serpentine structure 500 and then
connected to a rear end of a stretching wire 609 of the tip
assembly 600.
[0034] With the above configuration, the spring 205 is normally
extended such that the slider 204 is close to the toggle lever 202,
and the slider 204 is normally kept away from a front wall of the
holder 203. The spring 205 may be compressed by pressing the toggle
lever 202 downwardly. When being released, the toggle lever 202 is
returned to an original position by an elastic force of the spring
205. The holder 203 is formed with a cylindrical hole in the front
wall thereof. A rear end of the triangular wire joint 206 passes
through the cylindrical hole and the spring 205 and is fixedly
connected with the slider 204. The triangular wire joint 206 has an
axis coincident with the sliding axis of the slider 204. Manually
pulling the toggle lever 202 will drive the pull rod 207 to be
moved. Since the pull rod 207 is connected to one end of the slider
204, the linear movement of the slider 204 will drive the
triangular wire joint 206 to be moved.
[0035] Referring to FIGS. 2A and 2D, in some embodiments, the
control box assembly 300 further comprises two rotary switches 104
disposed symmetrically in the left-and-right direction on a rear
side of the partition plate 112 respectively and serving as
transmission components of the minimally invasive surgery control
box. The two rotary switches 104 have the same structure. Each
rotary switch 104 includes a swinging rod 402, at a top of which a
swinging wheel 401 is fixed, and a threaded bracket 403 formed with
a center hole in a top wall thereof and a cavity communicating with
the center hole in a middle portion thereof. The swinging rod 402
has a lower portion passing through the center hole of the threaded
bracket 403 and extending into the cavity. The swinging rod 402 is
engaged with the center hole of the threaded bracket 403 through a
clearance fit. An externally-toothed gear 302 is fixed to a bottom
portion of the swinging rod 402 located in the threaded bracket
403. An upper magnet assembly 408 is fixed to a bottom wall of the
external gear 302. The threaded bracket 403 is fixed to a threaded
seat 404 fixed onto the fixing plate 113 by a fixing bolt 405. An
internally-geared ring 301 is fixed in the threaded bracket 403. A
lower magnet assembly 409 is fixed to an inner wall of a bottom
portion of the threaded seat 404 opposite to the upper magnet
assembly 408. The externally-toothed gear 302 is supported on a
thrust spring 407. The upper magnet assembly 408 is wrapped within
the thrust spring 407. An upper end of the thrust spring 407 is in
contact with a lower end of the externally-toothed gear 302 in a
normal state, i.e., in a non-stressed state. The thrust spring 407
is fixedly connected with the lower magnet assembly 409 at a lower
end thereof. A packing washer 406 is sleeved or fitted over the
thrust spring 407 located at a lower portion of the
internally-geared ring 301 to radially fix the thrust spring 407,
thereby functioning as a limiting device. Axes of the
internally-geared ring 301 and the externally-toothed gear 302 are
coincident with the axis of the swinging rod 402. The swinging rod
402 is movable in an up-and-down direction to cause the
internally-geared ring 301 to engage with or disengage from the
externally-toothed gear 302. Sprockets 103 are mounted on the
swinging rod 402 located at an upper part of the threaded bracket.
The sprockets 103 include left and right sprockets 103 having the
same structure.
[0036] According to the above configuration, the thrust spring 407
is extended in the normal state, i.e., in the non-stressed state.
The externally-toothed gear 302 is brought close to an upper end
surface of an inner wall of the threaded bracket 403 by the
extending force of the spring, so that the externally-toothed gear
302 is not engaged with the internally-geared ring 301. By manually
rotating the swinging wheel 401, the swinging rod 402 is driven to
be rotated so as to drive the externally-toothed gear 302 to be
rotated. By manually pushing the swinging wheel 401 downwardly, the
externally-toothed gear 302 and the upper magnet assembly 408 move
downwardly together with the swinging wheel 401. The downward
movement of the externally-toothed gear 302 presses the thrust
spring 407 such that the thrust spring 407 is in a compressed
state. When a distance between the upper magnet assembly 408 and
the lower magnet assembly 409 becomes smaller, the upper magnet
assembly 408 is attracted to the lower magnet assembly 409. At this
time, the externally-toothed gear 302 and the internally-geared
ring 301 are located in a same plane and thus engaged with each
other, and friction contact of the internally-geared ring 301 with
the externally-toothed gear 302 prevents the swing wheel from being
rotated, thereby locking the control box assembly. The threaded
bracket 403 can fix the swinging rod 402 to some extent in an axial
direction. If the swinging wheel 401 is manually pulled upwardly,
the distance between the upper magnet assembly 408 and the lower
magnet assembly 409 becomes larger and an attractive force between
the magnet assemblies become smaller than the extending force of
the thrust spring 407. Thus, the externally-toothed gear 302 is
moved upwardly to be disengaged from the internally-geared ring 301
under the extending force of the thrust spring 407, thereby
unlocking the surgical control box assembly. The swinging rod 402
then continues to move upwardly to restore to its initial state,
and the externally-toothed gear 302 is in contact with the upper
end of the thread bracket 403, thereby realizing a non-linear
action switch.
[0037] Referring to FIG. 2B, when the rotary switch 104 is operated
to be moved upwardly so that the internally-geared ring 301 is
disengaged from the externally-toothed gear 302, the surgical
control box is unlocked. The swinging rod 402 is rotatable about
its own axis, and the sprockets 103 key-fitted with the swinging
rod 402 is rotated with rotation of the swinging rod 402. A set of
chutes 110 are fixed to the partition plates 112 at a front side of
each sprocket 103, respectively. Each set of chutes 110 includes
two chutes 110 disposed at a predetermined interval. The sprocket
103 on each swinging rod 402 is engaged with a chain 111
surrounding the sprocket 103. Each of the chains 111 has two free
ends disposed within the two chutes 110 of one set of the chutes
110, respectively. The chain 111 is driven by the swinging rod 402
to reciprocate linearly in the chutes 110. Both of the free ends of
each of the chains 111 are connected with one end of each of four
transmission wires 116, and the other end of each of the four
transmission wires 116 sequentially passes through the front sheath
assembly 101, the guide wire hole of the connection ring 702 and a
guide wire hole of the serpentine structure 500, and is then fixed
in an rear end opening of a tip body 607 of the tip assembly 600.
The transmission wire 116 is slidable back and forth in the guide
wire hole of the connection ring 702 so as to be tensioned and
relaxed, so that the serpentine structure 500 is moved in a bended
way by the pulling action of the transmission wire to achieve
actions of the distal hose assembly 400, thereby allowing operating
the front end of surgical apparatus to pitch and swing. The
transmission wires 116 may be connected with the serpentine
structure 500 by a known connection structure, and the transmission
wire 116 may be slidable in the guide wire hole. The rotary switch
104 is manually operated to be rotated about its own axis so as to
drive the sprockets 103 to be rotated together therewith, so that
the chains 111 fixedly connected onto the sprockets 103 are moved
linearly. The linear movement of the chains 111 drives the
transmission wire 116 to slide in the guide wire hole, and the
linear movement of the transmission wires 116 drives the serpentine
structure 500 of the surgical apparatus to be moved, thereby
achieving a desired surgical passage structure. When the rotary
switch 104 is pressed downwardly so that the internally-geared ring
301 is engaged with the externally-toothed gear 302, the rotary
switch 104 can not be rotated, thereby locking the control box
assembly. In this case, the transmission wire is kept in the
tensioning state so that the distal surgical tool is in a position
locking state. Referring to FIG. 1, the rotary switch 104 is
manually operated to drive the transmission wires 116 to be
tensioned and moved linearly, which allows the distal serpentine
structure 500 to be bent upwardly or downwardly and to swing in the
left-and-right direction, thereby adjusting the placement of the
surgical apparatus. The locking of the up-and-down pitch and
left-and-right swinging positions of the distal snake-bone
structure 500 is realized by the engagement state of the two sets
of gears. The realization of the up-and-down pitch and
left-and-right swinging movement may refer to a wire connection
structure disclosed in CN200910306053.5, thereby increasing the
range of reachable surgical space of the surgical apparatus.
[0038] Referring to FIGS. 2A and 2E, the control box housing 107 is
provided with two quick-change devices 105, which are arranged, as
important components for performing a minimally invasive surgery,
at left and right sides of a rear wall of the lower housing of the
control box housing 107, respectively. The two quick-change devices
105 include two lower connection sleeves 501 fixedly connected on
the left and right sides of the rear wall of the lower housing of
the control box housing 107, respectively. Each of the lower
connection sleeves 501 has a front end fixedly connected with the
rear end of the tool tube 114 at the corresponding side. Each of
the lower connection sleeves 501 is sleeved and fixed with an outer
telescopic sleeve 502 having a center hole into which a middle
telescopic sleeve 503 is slidably inserted. The middle telescopic
sleeve 503 has a center hole into which an inner telescopic sleeve
504 is slidably inserted. An upper connection sleeve 506 is fixed
to a rear end of the inner telescopic sleeve 504. The upper
connection sleeve 506 is symmetrically formed with two rectangular
slots of the same structure at either side along an axis thereof.
Two unlocking bars 507 of the same structure each comprise a
straight bar segment inserted into the rectangular slot at the
corresponding side through a clearance fit. The straight bar
segment has a rear end provided with a protruding hook hooked with
a groove in the surgical tool. Further, the straight bar segment
has a front end connected with a pressing plate. The bar segment of
each unlocking bar 507 is rotatably connected with the upper
connection sleeve 506 by a rotation shaft. A portion of the upper
connection sleeve 506 opposite to the pressing plate is fixedly
connected with a push rod 505 by a spring. When the unlocking bar
507 is rotated about the rotation shaft, the pressing plate may
contact with a top portion of the push rod 505.
[0039] When the surgical tool is inserted through the upper
connection sleeve 506 of the quick-change device 105, passes
through the middle hole of the inner telescopic sleeve 504 and is
positioned within the quick-change device 105, the groove within
the surgical tool is engaged with the hook of the unlocking bar 507
by frictionally pressing a front end of a bar end of the unlocking
bar 507. The straight bar segment of the unlocking bar 507 at a
front end thereof is pressed by a force against the pressing plate
at a rear end of the unlocking bar 507 so as to be in contact with
the push rod 505, so that the front end of the unlocking bar 507 is
held in a fixed position, thereby securing the surgical tool. The
pressing plate of the unlocking bar 507 is manually pressed to
compress the spring sleeved or fitted over the push rod 505,
thereby changing the cooperation relationship of the push rod 505
with the unlocking bar 507 of the quick-change device 105, so that
the straight bar section of the unlocking bar 507 is deflected
outwardly to disengage the hook on the front end of the unlocking
bar 507 from the groove within the surgical tool, thereby
disassembling the surgical tool for quickly replacing the surgical
tool.
[0040] In some embodiments, an air-water switch 106 may be
connected to the upper housing to facilitate the operation of the
surgeon. The water-gas switch 106 is connected with a water pipe to
access a water source. The water-vapor switch 106 may be turned on
to clean a lens, so that the surgeon can perform the surgery with
good visual field. Also, the water-vapor switch 106 may be turned
on to clean organ surface of the human body. During performing the
surgery, there may be bleeding. In this case, the air-water switch
106 is activated to clean the organs to be subject to the surgery,
which may improve security of the surgical operation. The air-water
switch 106 may have the existing structure in the prior art.
[0041] Referring to FIGS. 3A and 3B, the tip assembly 600 provides
a support passage for an end effector of the minimally invasive
surgical instrument. The tip assembly 600 enables connecting the
end effector of the surgical tool with the hose assembly 400 of the
surgical apparatus. The tip assembly 600 comprises a tip body 607
and an opening-closing body mounted in a middle groove of the tip
body 607. The opening-closing body includes two triangular rings
601 having the same structure and symmetrically arranged in the
left-and-right direction. A triangular pulling rod 610 is disposed
at a middle position between the two triangular rings 601. Each of
the triangular rings 601 is symmetrically provided with a
cylindrical boss 612 and a cylindrical hole 613 at either sides
thereof. The cylindrical boss 612 has an axis parallel to an axis
of the cylindrical hole 613 and perpendicular to the axis of the
triangular ring 601. Each of the cylindrical bosses 612 is
rotatably connected with one end of each of links 602 including two
front links 602 at a front side of the triangular pulling rod 610
and two rear links 602 at a rear side of the triangular pulling
rod. The other ends of the two front links 602 and the two rear
links 602 are respectively rotatably connected to front and the
rear ends of the triangular pulling rod 610 by pins 611. A front
end of a stretching wire 609 is vertically and fixedly connected
onto the triangular pulling rod 610. A triangular spring 608 is
sleeved or fitted over the stretching wire 609. A rear end of the
stretching wire 609 passes through a middle opening of the tip body
607 in which a boss is arranged. The triangle spring 608 is
disposed in the middle opening with a predetermined gap
therebetween and is fixedly connected to the boss at a lower end
thereof. When axes of the two triangular rings 601 are parallel
with each other, an upper end of the triangular spring 608 is in
contact with a bottom end of the triangular pulling rod 610, and
each cylindrical hole 613 is rotatably connected with a cylindrical
side of a triangular pin 603 fixed onto the tip body 607, so that
the triangular ring 601 is rotatable about the triangular pin 603.
As an implementation of the embodiments of the present disclosure,
the triangular pin 603 has a triangular prism structure. The tip
body 607 is formed with a triangular prism hole 615 into which the
triangular prism structure is fixed. The tip body 607 is provided
with arc grooves 614 in a middle slotted inner wall thereof
corresponding to the four cylindrical bosses 612. An end portion of
each cylindrical boss 612 of the triangular rings 601 is slidably
disposed in a corresponding one of the arc grooves 614. The
cylindrical boss 612 is slidable back and forth in the arc groove
614. The triangular pulling rod 610, the links 602, the triangular
pin 603 and the triangular ring 601 are rotatably connected
together to form a four-link mechanism.
[0042] The stretching wire 609 is pulled to move linearly downwards
so as to drive the triangular pulling rod 610 to compress the
triangular spring 608 to move downwards. The link 602 rotatably
connected to the triangular pulling rod 610 is pulled to be rotated
to drive the cylindrical boss 612 of the right triangular ring 601
to slide in the arc groove 614 in the tip body 607, so that the
triangular ring 601 is correspondingly rotated outwardly about the
triangular pin 603. Similarly, the rotation of the pulling rod 602
drives the left triangle ring 601 to be rotated outwardly, and
thereby the two triangular rings 601 are respectively rotated
outwardly so that a larger angle is formed between the two
triangular rings 601, thereby realizing movement output of the
triangular rings 601 of the distal tip assembly 600 of the natural
orifice translumenal surgical apparatus. In an initial attitude
shown in FIG. 3D, a small angle .theta..sub.1 is formed between the
left and right triangular rings 601. The triangular drive assembly
102 is manually operated and the stretching wire 609 is tensioned
to reach an attitude shown in FIG. 3E in which a large angle
.theta..sub.2 is formed between the left and right triangular rings
601, thereby outputting different output angles to obtain desired
surgical body position settings. The distal tip assembly is moved
by rotating the knob cap 201 of the control box by the surgeon,
thereby realizing an enlarged triangular surgical operation range
of the surgical apparatus.
[0043] The two surgical tools 100, 200 sequentially pass through
the connection sleeves 506 at the corresponding sides, the tool
tubes 114 of the control box at the corresponding sides, the front
sheath assembly 101 of the surgical apparatus, the tool hole of the
connection ring 702 of the hose assembly 400 and the serpentine
structure 500, respectively. The rear ends of the two surgical
tools 100 and 200 are fixed through the engagement of the groove
with the hook of the unlocking bar 507, respectively. The distal
end effector of each surgical tool passes through a surgical tool
passageway 605 and is disposed within the triangular ring 601 of
the tip assembly 600 of the surgical apparatus at the corresponding
side in a clearance fit manner, respectively. The end effector of
each surgical tool is passively disposed in the triangular ring 601
to be moved together with the triangular ring 601
correspondingly.
[0044] Referring to FIG. 4, the hose assembly 400 provides a
passageway for the minimally invasive surgical tool and the
transmission wire. The hose assembly 400 is in direct contact with
the natural orifice of the human body, thus has good softness
without damage to the natural orifice of the human body. In some
embodiments, the hose assembly 400 comprises an outer fixing sheath
701 fixedly connected with the front sheath assembly 101 to form a
unitary structure therewith. As an implementation, the outer fixing
sheath 701 is a rubber tube and is sequentially connected with the
connection ring 704 and an outer shell 703 at a front end thereof.
Four connection rings 702 are fixedly arranged within the out
fixing sheath 701 at a predetermined interval in a front-and-back
direction thereof. Each of the connection rings 702 is provided
with a plurality of cylindrical guide wire holes and two tool
holes. The surgical tools 100 and 200 pass through the tool hole of
the hose assembly 400. The serpentine structure 500 is installed
within the outer shell 703.
[0045] FIG. 6 is a schematic view of application of the natural
orifice translumenal minimally invasive surgical apparatus
according to an embodiment of the disclosure in a stomach surgical
operation. The end effector of the surgical tool of the minimally
invasive surgical apparatus 1 according to the embodiment of the
disclosure illustrated in FIG. 6 is extended into a stomach 3
through an esophagus 2 of the human body to perform a surgical
operation. The end effectors of the surgical tools 100, 200 are in
direct contact with the stomach 3 of the human body. The hose
assembly 400 of the surgical apparatus is in direct contact with
the esophagus 2 of the human body.
[0046] In some embodiments, the natural orifice translumenal
minimally invasive surgical apparatus is operated as follows.
[0047] With the natural orifice translumenal minimally invasive
surgical apparatus, the minimally invasive surgical tool is held by
the surgeon. The surgical apparatus is firstly placed properly by a
surgeon. The control box assembly 300 is fixed in position. The
different left and right rotary switches 104 are adjusted to
control different actions, respectively. The left rotary switch 104
performs a pitch motion of the distal serpentine structure 500 of
the surgical apparatus, and the right rotary switch 104 swings the
serpentine structure 500 in the left-and-right direction. Referring
to FIG. 1, the surgeon faces the control box assembly 300, which is
normally in an unlocked state, rotates the left rotary switch 104
counterclockwise to pitch upwardly the distal serpentine structure
500, and presses the rotary switch 104 downwardly to lock the
surgical control box assembly 300. At this time, the distal
serpentine structure 500 of the surgical apparatus is maintained in
an upward pitching state. If the rotary switch 104 is pulled
upwardly, the control box assembly 300 is unlocked. When the left
rotary switch 104 is rotated clockwise, the distal serpentine
structure 500 is pitched downwardly. When the control box assembly
300 is in the unlocked state under the normal condition, the right
rotary switch 104 is rotated counterclockwise to swing the distal
snake-bone structure 500 leftwards. Then, the rotary switch 104 is
depressed downwardly to lock the surgical control box assembly 300.
At this time, the distal serpentine structure 500 of the surgical
apparatus is maintained in a leftward swinging state. If the rotary
switch 104 is pulled upwardly, the control box assembly 300 is
unlocked. Then, the right rotary switch 104 is rotated clockwise to
swing the snake-bone structure 500 rightwards. In this case, the
rotary switch 104 is depressed downwardly to lock the control box
assembly 300. At this time, the distal serpentine structure 500 of
the surgical apparatus is maintained in the current state. Then,
the surgical tool is inserted into the passageway of the upper
connection sleeve 506 of the quick-change device 105 of the control
box assembly 300, and the surgical tool presses the straight bar
section of the unlocking bar 507 by friction, so that the groove in
the surgical tool is engaged with the hook of the unlocking bar
507, such that the end effector of the surgical tool sequentially
passes through the tool tube 114 of the control box, the front
sheath assembly 101, the hose assembly 400 and the serpentine
structure 500 of the surgical apparatus. The end effector of the
surgical tool is arranged at the tip assembly 600 of the surgical
apparatus with an operating handle end of the surgical tool being
connected with the quick-change device 105 of the control box
through the groove-hook engagement, so that the operating end of
the surgical tool is positioned at the quick-change device 105 at
the rear end of the control box and the end effector is disposed at
the tip assembly 600 of the surgical apparatus, thereby fixing the
surgical tool. Then, the triangle drive assembly 102 is adjusted by
manually pulling the toggle rod 202 rearwards to linearly pull the
transmission wire so as to drive the stretching wire 609 to be
moved, thereby opening the triangular rings 102 on the tip assembly
outwards, thus realizing movement output of the triangular ring 601
of the tip assembly 600 at the front end of the natural orifice
surgical translumenal apparatus. In this case, a larger angle is
formed between the two triangle rings 601 to change the position of
the end effector of the surgical tool so that the end effector is
as close as possible to the lesion tissue to form a better
operating triangle region. The air-water switch 106 then is turned
on for preparing to clean the organs. At this time, the surgical
apparatus is ready, and the surgeon then can start minimally
invasive surgery.
[0048] In order to overcome disadvantages in prior arts, an object
of the disclosure is to provide a natural orifice translumenal
minimally invasive surgical apparatus, which is small in volume,
convenient to use, flexible in operation and has a large triangular
region in surgical operation.
[0049] Finally, it should be noted that the above preferred
embodiments are merely intended to illustrate the technical
solutions of the disclosure, rather than limiting the scope
thereof. The disclosure and embodiments thereof have been described
above by way of illustration and the description is not
restrictive. The accompanying drawings merely show some of
embodiments of the disclosure, and the actual structure is not
limited thereto. Therefore, those skilled in the art should
understand that, without departing from the spirit of the
disclosure, the equivalent changes and modifications made according
to the scope of the disclosure, other transmission, drive devices
and connection manners, and other structures and embodiments being
similar to those in the technical solutions and designed without
inventive steps, should all fall within the scope of the
disclosure.
* * * * *